1. Field of the Invention
This invention is directed to hemostasis clip applying means, in general, and to a hand held, gun-like device which retains a plurality of hemostasis clips and automatically dispenses same on demand, in particular.
2. Prior Art
In performing many medical procedures, it is necessary to make incisions. It is just as necessary to properly close the incision.
Also, in accidents, injuries and the like, it is frequently the case that the skin of a person is cut or torn wherein appropriate closure techniques and devices are required.
Over the years, new and different techniques have been used in order to assure that the edges of wounds are brought together and retained in that position until the wound is closed and healed. Initially, this was accomplished merely by use of appropriate bandages, tapes and the like. Later, stitching techniques were developed using, inter alia, cat gut filaments or the like. These materials were then subsequently replaced by other materials such as, but not limited to nylon, surgical steel or the like depending upon the nature of the wound, the severity thereof and the location relative to the body. In some instances, it is desirable that the stitching material is soluble in body fluids. This type of stitching is normally used in internal procedures.
Other types of closure devices include so called butterfly clips which may be formed of metal or plastic with prongs which become imbedded in the skin surrounding the wound.
In other types of surgical procedures, for example neurosurgical or cranial types of surgery, a skin flap is formed. That is, an incison is made in the scalp of the patient. Typically, this incision is in the shape of a horseshoe. The skin flap, for example at the inner portion of the horseshoe, may be elevated, for example, by a periosteal elevator and, thus, becomes a "free flap". However, because the scalp is heavily vascularized, considerable bleeding is usually encountered. In the past, this type of incision was merely cauterized to stanch the flow of blood during the procedure. The incision was then sutured in the usual fashion for closure.
Subsequently, other closure devices, referred to as hemostasis clips have been developed. These hemostasis clips, typically, are in the form of a rolled piece of plastic with a gap between the ends thereof. These ends include toothed or rugose edges thereof. The rolled plastic strip incorporates or includes a "memory" which, in essence, forces the edges of the clip together. Thus, in order to use these clips, the clips are individually expanded or opened by use of manual forceps or the like. This causes the edges of the gap in the clip to spread apart. The expanded clip is then placed over the edges of the skin flap and the clip is permitted to close. The memory of the clip produces a firm, forced closure thereof so as to inhibit bleeding at the incised edge of the skin flap.
A typical example of this type of clip is referred to as a Raney clip which is manufactured by Codman and Shurteff and others. In the type of surgical procedure, described above, "Raney" type clips are placed on the edges of the elevated flap. When the flap has been fully clipped, the surgeon returns to the still attached sides and clips them also. This clipping procedure insures hemostasis of the incision, and the surgeon is free to begin to open the skull.
The hemostasis clips have found acceptance in the operating room because they have numerous advantages insofar as being cheap, non-toxic, non-invasive and so forth. However, the clips as currently utilized have a distinct disadvantage in that they are applied individually, usually require two hands for application and are very time consuming to apply. Because of the time involved, there is the disadvantage to the patient of time on the operating table, loss of blood, slow response time (by medical personnel) in emergency situations, and the like.
Consequently, it is highly desirable to develop a means and/or technique wherein a plurality of the Raney-type clips can be placed in a condition of readiness and applied to the appropriate incision area quickly and efficiently.